|
Blood draw capillary 36416
|
$20.00 |
$20.00 |
$20.00 |
|
|
Blood Draw (Venipuncture)
|
$25.60 |
$25.60 |
$25.60 |
|
|
Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic
|
$57.60 |
$57.60 |
$57.60 |
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$20.00 |
$20.00 |
$20.00 |
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$20.00 |
$20.00 |
$20.00 |
|
|
Blood occult peroxidase activity qualitative gastric
|
$22.40 |
$22.40 |
$22.40 |
|
|
Blood smear microscopic w manual differential wbc count
|
$34.40 |
$34.40 |
$34.40 |
|
|
Blood split unit
|
$388.80 |
$388.80 |
$388.80 |
|
|
Blood Transfusion
|
$844.80 |
$844.80 |
$975.20 |
|
|
Blood typing abo
|
$39.20 |
$39.20 |
$39.20 |
|
|
Blood typing ag donor ea ag
|
$162.40 |
$162.40 |
$162.40 |
|
|
Blood typing patient serum
|
$55.20 |
$55.20 |
$55.20 |
|
|
Blood typing rbc ag non abo/rh ea
|
$23.20 |
$23.20 |
$23.20 |
|
|
Blood typing rh (d)
|
$39.20 |
$39.20 |
$39.20 |
|
|
Blood typing rh phenotype complete reference
|
$44.00 |
$44.00 |
$44.00 |
|
|
Blood volume
|
$1,438.40 |
$1,438.40 |
$1,438.40 |
|
|
Bone Age X-ray (hand and wrist)
|
$184.00 |
$314.40 |
$315.20 |
|
|
Bone biopsy open superficial
|
$3,296.00 |
$3,296.00 |
$5,282.40 |
|
|
Bone Density Scan (DEXA)
|
$230.40 |
$242.40 |
$474.40 |
|
|
Bone filler cerament 10cc
|
$15,600.00 |
$15,600.00 |
$15,760.00 |
|
|
Bone imaging multiple areas
|
$966.40 |
$1,389.60 |
$1,417.60 |
|
|
Bone/joint imaging ltd area
|
$779.20 |
$956.80 |
$1,303.20 |
|
|
Bone marrow;aspiration only 38220
|
$2,192.00 |
$2,192.00 |
$2,364.00 |
|
|
Bone marrow biopsyneedle/trocar 38221
|
$2,354.40 |
$2,354.40 |
$2,588.00 |
|
|
Bone marrow imaging body
|
$1,556.00 |
$1,556.00 |
$1,556.00 |
|
|
Bone marrow imaging ltd
|
$717.60 |
$717.60 |
$818.40 |
|
|
Bone survey-lead poisoning
|
$255.20 |
$360.80 |
$538.40 |
|
|
Bone tendon board add on
|
$218.60 |
$218.60 |
$258.35 |
|
|
Boot j walker l
|
$241.75 |
$241.75 |
$307.16 |
|
|
Boot mlti podous univ xlg
|
$360.00 |
$360.00 |
$1,618.18 |
|
|
Boot softgait shrt m
|
$307.91 |
$307.91 |
$362.80 |
|
|
Boot walker genesis full shell 3-strap s
|
$227.23 |
$227.23 |
$376.85 |
|
|
Boot walker genesis mid-calf full shell s
|
$450.00 |
$450.00 |
$540.00 |
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$112.80 |
$112.80 |
$112.80 |
|
|
Bortezomib 3.5 mg (2.5 mg/ml) solution for subcutaneous injection
|
$2,083.00 |
$2,083.00 |
$3,654.84 |
|
|
Bowel imaging
|
$1,259.20 |
$1,259.20 |
$1,417.60 |
|
|
Brace afo dbl upright cust
|
$953.03 |
$953.03 |
$953.03 |
|
|
Brace afo lg left 6607
|
$36.10 |
$36.10 |
$36.10 |
|
|
Brace afopos solid ankle cust
|
$1,618.08 |
$1,618.08 |
$1,618.08 |
|
|
Brace afo spiral prefab
|
$1,121.29 |
$1,121.29 |
$1,392.86 |
|
|
Brace ank aftr bioskn med lg
|
$722.40 |
$722.40 |
$871.20 |
|
|
Brace ank air stirrup univ
|
$54.20 |
$54.20 |
$341.76 |
|
|
Brace ankle joint dflxn assist
|
$252.43 |
$252.43 |
$252.43 |
|
|
Brace ankle stablizing lg
|
$132.60 |
$132.60 |
$190.32 |
|
|
Brace back epic lo 627
|
$263.84 |
$263.84 |
$444.57 |
|
|
Brace back pinnacle lo 627 lumbar
|
$400.11 |
$400.11 |
$400.11 |
|
|
Brace back pinnacle tlso 464
|
$787.36 |
$787.36 |
$944.84 |
|
|
Brace back t-lso custom
|
$4,267.55 |
$4,267.55 |
$5,431.42 |
|
|
Brace back vista 464 tlso
|
$516.00 |
$516.00 |
$671.08 |
|
|
Brace fx hum ovr shldr sm
|
$375.57 |
$375.57 |
$631.10 |
|
|
Brace knee 32in univ t-scope short lt/rt
|
$653.16 |
$653.16 |
$839.78 |
|
|
Brace knee extender plus 22-30in
|
$259.02 |
$259.02 |
$590.01 |
|
|
Brace knee hing pat open med
|
$305.60 |
$305.60 |
$345.14 |
|
|
Brace knee playmaker ii x-rom hook and loop xl
|
$365.73 |
$365.73 |
$538.56 |
|
|
Brace knee postop tscope xl
|
$1,232.16 |
$1,232.16 |
$2,421.84 |
|
|
Brace knee support neoprene padded open patella med
|
$126.18 |
$126.18 |
$313.85 |
|
|
Brace m arm board
|
$306.20 |
$306.20 |
$323.20 |
|
|
Brace or Splint Fitting and Training (each 15 minutes)
|
$122.40 |
$122.40 |
$134.40 |
|
|
Brace ortho exos 28-50in sm
|
$510.40 |
$510.40 |
$903.95 |
|
|
Brace ortho tlso 2xl 19in strnl y bar wst belt pd shldr
|
$1,043.57 |
$1,043.57 |
$1,043.57 |
|
|
Brace oths wrist hnd fngr without
|
$279.52 |
$279.52 |
$315.69 |
|
|
Brace tlso flex cust
|
$1,048.19 |
$1,048.19 |
$1,257.82 |
|
|
Brace wrist classic lft sm
|
$116.39 |
$116.39 |
$167.04 |
|
|
Brach/thor cath 1st
|
$3,444.80 |
$3,444.80 |
$3,992.80 |
|
|
Brach/thor cath 2nd
|
$3,732.80 |
$3,732.80 |
$3,956.80 |
|
|
Brach/thor cath 3rd
|
$3,978.40 |
$3,978.40 |
$6,535.20 |
|
|
Brach/thor cath addl
|
$648.80 |
$648.80 |
$3,012.00 |
|
|
Brachy source yttrium-90
|
$29,856.80 |
$29,856.80 |
$37,407.20 |
|
|
Brachy src nonstrand hdr ir-192
|
$904.00 |
$904.00 |
$904.00 |
|
|
Brachytx isodose complex
|
$1,013.60 |
$1,013.60 |
$2,101.60 |
|
|
Brachytx isodose intermed
|
$750.40 |
$750.40 |
$1,696.00 |
|
|
Brachytx isodose plan simple
|
$571.20 |
$571.20 |
$1,260.80 |
|
|
Brain flow imaging only
|
$732.80 |
$732.80 |
$749.60 |
|
|
Brain image 4+ views
|
$600.00 |
$600.00 |
$600.00 |
|
|
Brain image w/flow 4 + views
|
$1,157.60 |
$1,157.60 |
$1,332.80 |
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$3,496.80 |
$3,603.20 |
$3,644.00 |
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$2,548.80 |
$2,732.00 |
$2,922.40 |
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$2,216.00 |
$2,276.80 |
$2,667.20 |
|
|
Brain MRI (with and without contrast)
|
$3,331.20 |
$3,730.40 |
$4,347.20 |
|
|
Brain MRI (with contrast)
|
$2,740.00 |
$3,088.80 |
$3,248.00 |
|
|
Brain MRI (without contrast)
|
$2,140.00 |
$2,140.00 |
$2,948.00 |
|
|
Breast Biopsy (ultrasound-guided, percutaneous)
|
$3,222.40 |
$3,222.40 |
$3,364.00 |
|
|
Breastbone (Sternum) X-ray
|
$160.80 |
$330.40 |
$363.20 |
|
|
Breast punct aspir cyst, bil
|
$1,333.60 |
$1,333.60 |
$1,343.20 |
|
|
Breath hydrogen test 91065
|
$388.80 |
$388.80 |
$792.80 |
|
|
Brentuximab vedotin 50 mg intravenous solution
|
$7,055.00 |
$7,055.00 |
$20,270.58 |
|
|
Brexucabtagene car pos t
|
$1,418,535.20 |
$1,418,535.20 |
$1,418,535.20 |
|
|
Bronch/asp/tracheobronch tree/subs 31646
|
$2,363.20 |
$2,363.20 |
$2,616.80 |
|
|
Bronch ebus ivntj perph les 31654
|
$695.20 |
$695.20 |
$695.20 |
|
|
Bronch ebus samplng 1/2 node
|
$4,691.20 |
$4,691.20 |
$4,691.20 |
|
|
Bronch ebus samplng 3/> node
|
$4,868.80 |
$4,868.80 |
$4,868.80 |
|
|
Bronchial allergy tests
|
$628.00 |
$628.00 |
$815.20 |
|
|
Bronchial challenge
|
$517.60 |
$517.60 |
$1,109.60 |
|
|
Bronchoscopy bronch stents
|
$6,104.00 |
$6,104.00 |
$6,104.00 |
|
|
Bronchoscopy clear airways 31645
|
$2,599.20 |
$2,599.20 |
$2,871.20 |
|
|
Bronchoscopy dilate/fx repr
|
$2,901.60 |
$2,901.60 |
$2,901.60 |
|
|
Bronchoscopy dilate w/stent
|
$7,715.20 |
$7,715.20 |
$7,715.20 |
|
|
Bronchoscopy/lung bx addl 31632
|
$1,885.60 |
$1,885.60 |
$1,885.60 |
|
|
Bronchoscopy/lung bx each 31628
|
$3,571.20 |
$3,571.20 |
$3,571.20 |
|
|
Bronchoscopy/needle bx addl 31633
|
$2,173.60 |
$2,173.60 |
$2,173.60 |
|
